www.npca.org.uk [email protected] national prostate cancer audit heather payne, npca oncological...

www.npca.org.uk [email protected]

National Prostate Cancer Audit

Heather Payne, NPCA Oncological Clinical LeadConsultant Clinical Oncologist, UCL


Prostate Cancer• Most common solid cancer in men & second most common

cause of cancer death in UK men, after lung cancer

• 40,000 new cases and 10,000 deaths/year– 110 men are diagnosed each day (30 deaths/day)

• Variable course in different patients– High risk = aggressive & fast growing (clinically significant) vs low risk =

localised & slow growing (clinically insignificant disease)

Cancer Research UK. Prostate cancer statistics, 2014


Prostate Cancer Disease Staging

(MDT) Multi-disciplinary Team Guidance for Managing Prostate

Cancer

• British Association of Urological Surgeons (BAUS) Section of

Oncology• British Uro-oncology Group

(BUG)• British Prostate Group (BPG)


Prostate Cancer (2)• An increasing number of men are living with a diagnosis of

low-risk localised disease without evidence of spread beyond the prostate– A key concern is the potential for patients with low-risk disease to

undergo radical treatments

• Men with high-risk localised or locally advanced disease are more likely to develop progression and to die of their disease– May not be getting the radical treatments (multimodal therapy) that

they need

www.npca.org.uk [email protected] * High-risk localised prostate cancer is also included by NICE for the same therapy options as locally advanced prostate cancer


Background

• Healthcare Quality Improvement Partnership (HQIP) established in 2008 to promote quality in healthcare– Increase the impact of clinical audit on healthcare quality

• HQIP set up the National Clinical Audit and Patient Outcomes Programme (NCAPOP)– Commissions large scale audits

• Acute, Cardiac, Long-term conditions, Mental health, Older people, Women & Children

• Cancer – bowel, head & neck, oesophogastric, lung


National Prostate Cancer Audit (NPCA)

• Commissioned by HQIP as part of the NCAPOP programme• Contract awarded to the Clinical Effectiveness Unit, RCS• Managed as partnership with BAUS, BUG and NCRS• Audit initiated in April 2013, minimum of 5 years


Governance Structure

• Project Team: undertake all activities required to deliver the audit (based in CEU of RCS)

• Project Board: oversee the delivery of the contract

• Clinical Reference Group: support implementation of the audit


Clinical Reference Group• Same Chair as NCIN Urology Site-specific CRG (Roger

Kockelbergh) -> avoid overlap and ensure cross fertilisation

• Members from– BAUS– BUG– BAUN– RCGP– Patient and public reps (Prostate Cancer UK, Tackle Prostate Cancer)– NCIN– National Peer Review– National Commissioning Board– Specialised Urology CRG, NHS England


National Prostate Cancer Audit• Aim:

– assess the process of care and outcomes in men diagnosed with prostate cancer in England and Wales

• Key audit topics: – service delivery and organisation of care– characteristics of newly-diagnosed prostate cancer, how the cancer was

detected and the referral pathway– diagnostic and staging process– planning of initial treatment & treatments received – patient experience and health outcomes 18 months after diagnosis– overall and disease-free survival– feasibility of a PSA testing audit in primary care


Audit Topics and Objectives• Audit Topics

– For each trust we will describe:• Presenting stage and risk stratification • Prostate cancer treatments received• Patient experience and quality of life 18 months after radical

prostate cancer therapy

• Audit Objectives– Report

• Use of active surveillance for men with low risk prostate cancer• Use of appropriate radical therapy for high risk prostate cancer• Outcomes following radical treatments• Use of PSA testing


Key Objectives: Year 1

• Carry out an organisational audit of prostate cancer care in England and Wales

• Analyse existing data to provide comparative background data for the audit

• Design a national data collection system and a short and simple minimum dataset for the prospective audit

• Scoping of feasibility study for audit of PSA testing in primary care


Published on the 10th November 2014

Available for download from our website


Key Objectives: From Year 2

• Collect prospective data from each newly-diagnosed patient discussed at a MDT meeting

• Initiate data collection in April 2014 and will continue throughout the audit• Data collection started in England in April • Data collection in Wales delayed until April 2015


Key Objectives: From Year 3

• Collect PROMs and PREMs from all patients with localised prostate cancer who are candidates for radical treatment 18 months after diagnosis

• Data collection will start in October 2015 and will continue throughout the audit


What improvements are anticipated?

• Appropriate use of active surveillance for men with low risk prostate cancer based on patient choice

• Appropriate use of multimodality for men with high risk or locally advanced prostate cancer

• Improved safety and toxicity profile of prostate cancer therapy

• Reduced variation in prostate cancer therapy across NHS trusts

• Findings from the feasibility study of PSA testing will guide the planning of a national approach for the diagnosis of prostate cancer in line with men’s preferences


Thank you!

The success of the NPCA is dependent on your continuing

support


‘A national clinical audit of prostate cancer care will improve clinical practice and patient outcomes, and ultimately save lives. The success of this audit has our full support and commitment.’ − Adrian Joyce, President of BAUS (until June 2014)

‘BUG supports NPCA as it is a fantastic opportunity to provide accurate data directly from MDTs with minimal administrative burden on staff and patients alike. This will improve the quality of care and outcome of patients nationwide.’ − Simon Russell, Secretary of BUG

www.npca.org.uk [email protected] national prostate cancer audit heather payne, npca oncological...

Documents

prostate cancer statistics

advanced prostate cancer

lung cancer

audit slide

public reps prostate

national clinical audit

common solid cancer

lung slide